It has now been revealed that antidepressant therapy that was once utilized to avoid risk of suicide may actually fail to lower the threats. A recent report from the Archives of General Psychiatry indicated that antidepressant therapy among adults which aims to reduce the risk of suicide or suicide attempts fails to vary by individual type or class of medication.
The report states that despite the widespread use of antidepressant medications, particularly selective serotonin reuptake inhibitors (SSRIs), there seemingly lacks inconsistent evidence that growth in antidepressant use has reduced the prevalence of suicidal ideation or suicide attempts during the past decade.
Increased risk in suicidal thoughts and behaviors among children and adolescents taking antidepressants first appeared in the research conducted in October 2004 by the U.S. Food and Drug Administration. However, the subsequent research showed that antidepressants did not increase suicidal thoughts. Nevertheless, these analyses and advisories did not seem to provide the patients, clinicians or policy makers with adequate guidance on treatment decisions.
Sebastian Schneeweiss, M.D., Sc.D., of Brigham and Women’s Hospital and Harvard Medical School, Boston, and colleagues wrote, ‘In the current study, we sought to address whether the risk of suicide is equal across antidepressant classes and agents after adjustment for selection factors—or whether there are particular regimens with safety advantages that should be prescribed preferentially in adult populations.’
Health care utilization data from 287,543 adults in British Columbia, Canada, who had initiated antidepressant therapy between 1997 and 2005, was analyzed by these researchers. The report seemingly indicated that amongst a total of 846 adults 751 attempted suicide and 104 completed suicides in the first year of antidepressant use itself. However, almost all these events occurred in the first six months after beginning the treatment itself.
It has to be considered that no clinically meaningful difference in risk appeared among individuals taking different classes of medications, including SSRIs, serotonin-norepinephrine reuptake inhibitors, tricyclic agents and other newer and atypical agents. Also, significant differences failed to appear among individual medications, including fluoxetine, citalopram, fluvoxamine, paroxetine and sertraline.
The report is published in the May issue of Archives of General Psychiatry, one of the JAMA/Archives journals.